Influence of personality traits and clinical role models on changes in medical students' attitudes toward psychiatry: a prospective moderation analysis.
Fajwani Hajir H, Al-Mahrouqi Tamadhir T, Al-Harthi Ali A, Al-Alawi Mohammed M
Oman faces a critical shortage of psychiatrists, highlighting the need to better understand determinants of medical students' career attitudes toward psychiatry. Utilizing Social Learning Theory and Situational Strength Theory, this study examined how attitudes toward psychiatry evolve during clinical training through the interaction between individual characteristics (personality traits) and contextual influences (clinical learning environment and role models). The study aimed to determine whether personality traits and exposure to clinical role models moderate changes in students' attitudes during the psychiatry clerkship. A prospective single-group quasi-experimental pre-post study was conducted among 180 undergraduate medical students at Sultan Qaboos University during an eight-week psychiatry clerkship. Attitudes toward psychiatry and personality traits were assessed using the Attitudes Toward Psychiatry-30 (ATP-30) and Big Five Inventory-44 (BFI-44) scales. Moderation analyses were performed using Hayes' PROCESS macro to evaluate interaction effects between baseline attitudes, personality traits, and perceived role-model influence. Attitudes toward psychiatry improved significantly following clerkship exposure (mean ATP-30 score increased from 105.66 to 110.38; p < .001). Personality traits did not significantly moderate attitude change. However, perceived resident role-model quality demonstrated a significant interaction with baseline attitudes (b = - 0.953, p = .004), with the greatest improvement observed among students with initially less favorable attitudes toward psychiatry. Prior personal contact with mental health services was independently associated with lower post-clerkship attitude scores (b = - 4.553, p = .047). Psychiatry clerkships were associated with improved student attitudes, with role-model mentorship appearing more consequential than stable personality characteristics. As improved attitudes do not consistently translate into specialty recruitment, workforce strategies should move beyond passive clinical exposure toward structured mentorship, targeted career engagement, and culturally responsive psychiatric training models.